高原地区单中心五年肾癌临床病理特点分析

目的分析高原地区单中心近5年收治的肾细胞癌患者的临床病理特点。 方法收集2017年1月1日至2021年12月31日期间于西藏自治区人民医院泌尿外科住院行手术治疗且术后标本病理学被明确诊断为肾细胞癌患者的临床病理资料，分析肾细胞癌患者的一般资料、肿瘤大小、病理学特点、TNM分期、临床表现及分期、手术情况。 结果68例肾细胞癌患者中男性43例（63.2%），女性25例（36.8%），男女比例为1.72∶1。发病年龄范围为22~85岁，中位年龄为56.5（50.0~61.8）岁，高发年龄段为50~70岁（72.1%）。68例肾细胞癌患者中藏族患者66例（97.0%），门巴族患者1例（1.5%），回族患者1例（1.5%）；城镇地区患者20例（29.4%），农村地区患者48例（70.6%），城乡比例约为1∶2.4。68例肾细胞癌患者中通过体检或检查发现29例（42.6%），出现相关临床症状后就诊者39例（57.4%）。主要病理类型为肾透明细胞癌55例（80.9%）。68例肾细胞癌患者中行腹腔镜辅助下根治性肾切除术45例（66.2%），腹腔镜辅助下肾部分切除术14例（20.6%），开放根治性肾切除术5例（7.4%），开放肾部分切除术2例（2.9%），腹腔镜中转开放根治性肾切除术2例（2.9%），其中腹腔镜经腰入路44例（64.7%），腹腔镜经腹入路15例（22.1%）。 结论本中心主要为藏族患者，主要病理类型仍为肾透明细胞癌。男性患者比例高于女性，农村地区病例数为城市地区的2.4倍，高发年龄段为50~70岁。有临床症状就诊者占比较高，主要术式为经腰入路腹腔镜辅助下根治性肾切除术。

Clinicopathological features of patients with renal cell carcinoma in plateau region: 5-year single center analysis

ObjectiveTo analyze the clinicopathological features of patients with renal cell carcinoma admitted to a single center in a plateau area in the past 5 years. MethodsThe clinicopathological data of patients with renal cell carcinoma who underwent surgical treatment at the Department of Urology of the People's Hospital of Tibet Autonomous Region from January 1, 2017 to December 31, 2021 were collected. The general data, tumor size, pathological characteristics, TNM stage, clinical manifestations and stage, and surgical conditions of these patients were analyzed. ResultsAmong the 68 patients with renal cell carcinoma included, 43 were male (63.2%) and 25 were female (36.8%), with a male-to-female ratio of 1.72∶1. The age of onset ranged from 22 to 85 years old, with a median age of 56.5 (50.0~61.8) years old, and the high incidence age group was 50~70 years old (72.1%). Among the 68 patients with renal cell carcinoma, 66 were Tibetan (97.0%), 1 was Menba (1.5%), and 1 was Hui (1.5%); there were 20 patients (29.4%) in urban areas and 48 (70.6%) in rural areas, with an urban-rural ratio of about 1∶2.4. Twenty-nine patients (42.6%) were found by physical examination or examination, and 39 (57.4%) were diagnosed after the presence of related clinical symptoms. The main pathological type was renal clear cell carcinoma in 55 cases (80.9 %). Forty-five cases (66.2%) underwent laparoscopic-assisted radical nephrectomy, 14 (20.6%) underwent laparoscopic-assisted partial nephrectomy, 5 (7.4%) underwent open radical nephrectomy, 2 (2.9%) underwent open partial nephrectomy, and 2 (2.9%) underwent laparoscopic conversion to open radical nephrectomy. Nephrectomy was performed via a laparoscopic translumbar approach in 44 cases (64.7%) and via a laparoscopic transabdominal approach in 15 (22.1%). ConclusionThe patients included in this study are mainly Tibetan, and the main pathological type is clear cell renal carcinoma. The proportion of male patients is higher, the number of cases in rural areas is 2.4 times of that in urban areas, and the high incidence age group is 50~70 years old. Patients with clinical symptoms account for a relatively high proportion, and the main procedure is laparoscopic-assisted radical nephrectomy via a lumbar approach.